This General and Statutory Power of Attorney is intended to be used by an individual to grant an agent powers with respect to his or her property and financial matters. It will enable the agent to make decisions and act on behalf of the principal with broad powers or the principal may list the specific powers granted to the agent. This power of attorney becomes effective upon execution until the principal's death, disability or incapacity. This document is useful for individuals located in Wyoming who wish to appoint an agent to act on their behalf.
Docstoc Legal Agreements This General and Statutory Power of Attorney is intended to be used by an individual to grant an agent powers with respect to his or her property and financial matters. It will enable the agent to make decisions and act on behalf of the principal with broad powers or the principal may list the specific powers granted to the agent. This power of attorney becomes effective upon execution until the principal's death, disability or incapacity. This document is useful for individuals located in Wyoming who wish to appoint an agent to act on their behalf. ® DISCLAIMERS: ALL INFORMATION AND FORMS ARE PROVIDED “AS IS” WITHOUT ANY WARRANTY OF ANY KIND, EXPRESS, IMPLIED, OR OTHERWISE, INCLUDING AS TO THEIR LEGAL EFFECT AND COMPLETENESS. They are for general guidance and should be modified by you or your attorney to meet your specific needs and the laws of your state. Use at your own risk. 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All Rights Reserved GENERAL AND STATUTORY POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: I, ________________________________ [Instruction: Insert the name of principal] hereinafter termed as the “Principal”, residing at ___________________ [Instruction: Insert the Address of Principal], County of ______________ [Instruction: Insert the County], State of Wyoming, do hereby make, constitute and appoint ________________________________ [Instruction: Insert the name of attorney in fact/agent], hereinafter termed as “Agent”, residing at ___________________ [Instruction: Insert the Address of attorney in fact], my true and lawful attorney in fact for me and in my name and behalf. My Agent shall have full power and authority to perform any act, power, duty, legal right, or obligation whatsoever that I now have or may later acquire in connection with or relating to any person, item, transaction, thing, business, property, real or personal, tangible, or intangible, or matter whatsoever as I could do if personally present. I hereby ratify and confirm all acts that my Agent, or my Agent’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights hereby granted. My Agent’s powers and authority shall include, but not be limited to: (__)Real Estate property transactions; (__)Tangible personal property transactions; (__)Stock and bond transactions; (__)Commodity and option transactions; (__)Banking and other financial institution transactions; (__)Business operating transactions; (__)Insurance and annuity transactions; (__)Estate, trust, and other beneficiary transactions; (__)Claims and litigation; (__)Personal and family maintenance; (__)Benefits from social security, Medicare, Medicaid, or other governmental programs or civil or military service; (__)Retirement plan transactions; (__)Tax matters, including any transactions with the Internal Revenue Service; (__)Decisions regarding lifesaving and life prolonging medical treatment; © Copyright 2013 Docstoc Inc. registered document proprietary, copy not 2 (__)Decisions relating to medical treatment, surgical treatment, nursing care, medication, hospitalization, institutionalization in a nursing home or other facility and home health care, (__)Transfer of property or income as a gift to the principal's spouse for the purpose of qualifying the principal for governmental medical assistance. [Instruction: Mark an ‘X’ next to desired powers and draw a line through those you do not wish to include] IF NO POWER LISTED ABOVE IS CROSSED OUT, THIS DOCUMENT MAY BE CONSTRUED AND INTERPRETED AS A GENERAL POWER OF ATTORNEY AND MY AGENT (Attorney-in-Fact) MAY HAVE THE POWER AND AUTHORITY TO PERFORM OR UNDERTAKE ANY ACTION I COULD PERFORM OR UNDERTAKE IF I WERE PERSONALLY PRESENT. SPECIAL INSTRUCTIONS: (Optional) I grant my Agent the power to apply my property to make gifts, except that the amount of a gift to an individual may not exceed the amount of annual exclusions allowed from the federal gift tax for the calendar year of the gift. [Comment: In the following space, the Principal may give special instructions limiting or extending the powers granted to Agent]. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ This power of attorney becomes effective immediately and shall remain effective until my death or until my disability or incapacity. As used herein, “disability” or “incapacity” shall mean a lack of capacity to receive and evaluate information effectively, to communicate decisions, and/or to manage my financial resources and affairs properly. This Power of Attorney shall be construed broadly as a General Power of Attorney. The listing of specific terms, rights, acts, or powers are not intended to restrict or limit the definition or scope of powers granted herein in any manner. If any part of this document is held to be invalid, illegal, or unenforceable under applicable law, then the remaining unaffected parts of the document shall still remain in full force and effect and not be affected by any partial invalidity. Any third party who receives the copy of this document may act under it. Revocation or termination of the power of attorney is not effective as to a third party until the third party has actual notice or knowledge of such revocation or termination, and I, for myself and for my heirs, executors, legal representatives, and assigns, hereby agree to indemnify and hold harmless any such third party from and against any and all claims that may arise against such third party by reason of such third party having relied on the provisions of this instrument. © Copyright 2013 Docstoc Inc. registered document proprietary, copy not 3 Successor Agent: If the Agent named by me shall die, become incompetent, resign, or refuse to accept the office of Agent, I name the following (each to act alone and successively, in the order named) as successor(s) to such Agent: ______________________________________________________________________________ ______________________________________________________________________________ [Instructions: Insert the name(s) and address(es) of such successor(s) in the following paragraph.) [Comment: Choose this clause if you or the Principal wish to name the successor(s) of the Agent]. Neither the Agent nor his/her successor(s) shall be liable for losses resulting from judgment errors made in good faith. However, Agent will be liable for breach of fiduciary duty, failure to act in good faith, and/or willful misconduct, while acting under the authority of this Power of Attorney. I may revoke this Power of Attorney at any time by providing written notice to my Agent. Signed this ______ [Month] ____ [Date], 20___ [Year]. _______________________________________ [Instruction: Insert the signature of Principal] ___________________________________________ [Instruction: Insert the printed name of Principal] _______________________________________ [Instruction: Insert the signature of Agent] ___________________________________________ [Instruction: Insert the printed name of Agent] © Copyright 2013 Docstoc Inc. registered document proprietary, copy not 4 ACKNOWLEDGMENT STATE OF Wyoming COUNTY OF ______________________ [Instruction: Insert County On the day of _____________________ [Instruction: Insert date], before me, the undersigned, a Notary Public in and for said State, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument, and that such individual made such appearance before the undersigned in _____________________________________________ [Instruction: Insert city/political subdivision and county or state or other place where acknowledgment taken] ________________________________________________ (Signature and office of individual taking acknowledgment) My commission expires: _________________________ THE ATTORNEY IN FACT OR AGENT, BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT. © Copyright 2013 Docstoc Inc. registered document proprietary, copy not 5
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